French delegation on telemedicine, March 25, 2014

1. Medisat
VideoKOLouh_briefcase_en.mp4

2. Medisat A/S makes
Welfare Technology Solutions,
for the Danish Healthcare System

3. The Beginning…
• In 2006, Odense University Hospital in Denmark, asked Medisat A/S to
develop a “Patient Briefcase“, so the doctors would be able to treat COPD
patients in their own homes.
• The goal was freeing up hospital-beds, for other patient groups.
Stable COPD Unstable COPD

4. Numbers off COPD patients,
in different countries
Countries Population COPD ptt Market
7,45% 10%
Denmark 5.400.000 402.300 40.230
Sweden 9.000.000 670.500 67.050
Finland 5.200.000 387.400 38.740
Norway 4.600.000 342.700 34.270
Scandinavia 24.200.000 1.802.900 180.290
Germany 82.500.000 6.146.250 614.625
Belgium 10.400.000 774.800 77.480
Greece 11.100.000 826.950 82.695
Spain 43.000.000 3.203.500 320.350
France 60.000.000 4.470.000 447.000
Italy 58.500.000 4.358.250 435.825
The Nederlands 16.300.000 1.214.350 121.435
Austria 8.200.000 610.900 61.090
Poland 38.200.000 2.845.900 284.590
Portugal 10.500.000 782.250 78.225
Great Britain 60.000.000 4.470.000 447.000
Canada 30.800.000 2.294.600 229.460
Switzerland 7.300.000 543.850 54.385
USA 300.000.000 22.350.000 2.235.000
The West 761.000.000 56.694.500 5.669.450

5. Hospital
Municipality
&
General practitioners
The Patient
COPD is a serious disease:
• 9 % dies during hospitalization
• 19% are dead after 3 months
• 36 % are dead after 1 year
400.000 people suffers from COPD in DK
Source: Danmarks Lungeforening
Severe & very severe COPD -
up to 10-12% of patients
Moderate COPD
15 – 20 % of ptt
ptt.
Light COPD
65 – 70% of ptt
Medisat target group
Lung function below 30%
Lung function below 50 %
© Ophavsret – Copyright by Medisat A/S

6. Challenge # 1
• Our patients/ clients are aged 65+
• Fear of computers or inexperienced
• It was a demand that “The Patient Briefcase” should be very
easy to use
• Important to avoid:
– Viruses
– Updating
– Blue screen
– Faulty use

7. Chronic Obstructive Pulmonary Disease
• A “COPD” patient in Denmark is typically hospitalized 4-5 times
a year.
• This patient occupies one hospital bed 4-5 days per admission.
• At OUH, the patient is discharged within 24 hours of hospitalization.
• The treatment will continue in the patients own home via the Patient
Briefcase
• With The Patient Briefcase, we are saving 20 days of hospitalization
per patient per year.

8. At the hospital
1) Pulse + pulse-oximeter – Oxygen saturation in the
blood
2) FEV 1: ”Forced expired volume in the first second”
3) FVC: Total lung capacity + how much the patient can
exhale in total

9. The Patient Briefcase
COPD

10. © Ophavsret – Copyright by Medisat A/S
”The three-button-system”
100% real time data

11. Electronic Patient Data System
in the patients home
© Ophavsret – Copyright by Medisat A/S
1) Pulse + pulse-oximeter – Oxygen-saturation in the blood
2) FEV 1: ”Forced expired volume in the first second”
3) FVC: Total lung capacity + how much the patient can exhale in total

12. Patient satisfaction
Will you recommend that the briefcase is offered to other patients in your situation?
Sp. 16
Yes 97%
No 0%
Do not know/
irrelevant
3%
Respondents 100%
© Ophavsret – Copyright by Medisat A/S
97%
3%
YES
NO
Don't know

13. © Ophavsret – Copyright by Medisat A/S
Teknologi

14. Datatilsynet logning af data
© Ophavsret – Copyright by Medisat A/S
Teknologi

15. © Ophavsret – Copyright by Medisat A/S
Teknologi
Integration

16. The Clinical Respiratory Journal
The documentation has taken 4 years.

17. Re-admissions
Further gains
Telemedicine
patient:
(n: 50)
Control patient:
(n: 50)
Total number of re-admissions 8
improvement
of 46%
15
Total number of re-admission days 37 (4,6)
improvement
of 68%
116 (7,7)
Total number of re-admissions with
impairments
6
improvement
of 45%
11
Re-admission days with impairments 15(2,5)
(3 <1 days)
improvement
of 69%
48 (4,4)
(2<1 days)

18. Studies at OUH, Denmark
• PhD Study; 266 patients have been through this study.
• Read Anne D. Sorknæs' Ph.d. Thesis: "The effects of real-time telemedicine video
consultations between nurses and patients with severe Chronic Obstructive
Pulmonary Disease (COPD)“
• 2.504 patients have so far been treated with the Briefcase

19. Time frame
Year
Type
2009 ->2006 2007 -2008
V.30 V.32 V.35 HD
2011 ->
Apollo

20. Version 4

21. How does it work ?
• VideoKOLKOLSkoffertEngelsk - Kopi.wmv

22. At the patients home

23. OUH and Svendborg Hospital
• Every day the clinical staff make their ward-rounds at their medical
departments
• Find the relevant patients
• Fill out a form
• 4 hours later the patient can begin treatment in his/her own home

24. 4 hours later...
The treatment can begin in the patients own home

25. Bringing the hospital to you!
• There is a big difference between running the logistics at a hospital and
running it within the patients own home
• Suddenly new demands become obvious:
– Internet access
– Installation – education
• Sick patients are often very tired and have no energy
– Taking-down the briefcase

26. Heart failure
• Reduces the treatment time
– From 3 months to 1 month
• Blood pressure
• ECG
• Weight
• Blood analysis CHEM8+
Sodium(Na)
Potassium(K)
Chloride(CI)
Ionizes Calcium(iCa)
TCO2
Glucose(Glu)
Urea Nitrogen(BUN)/Urea
Creatinini(Crea)
Hematocrit(Hct)
Hemoglobin*(Hgb)
© Ophavsret – Copyright by Medisat A/S
World
news

27. Acute heart failure patients
• In collaboration with Faaborg-Midtfyns Municipality and OUH Svendborg
Hospital
• Complete blood analysis - real time data from the home of the patient/
client and directly to the hospital in only 2 minutes
Blood analysis

28. Maternity women
November 1st, 2011 RSD - Mother and child are
sent home 4 hours after the birth

29. Psychiatry
Child/Youth Psychiatry – video solution
• Schizophrenia
• Manic - depressive
• Anorexia

30. What direction should we choose?

31. 31
Key Figurs 2012
• TREFOR koncernens nettoomsætning 2,2 mia. DKK
• Balance 10,6 mia. DKK
• Egenkapital 4,4 mia. DKK
• Investeringer 0,8 mia. DKK
• 545 engagerede medarbejdere pr. 1. november 2013

32. 32
Koncernens funktioner
TREFOR
Fælles koncernfunktioner
Forsyning Energi Entreprise Bredbånd
El-net
Varme
Vand
Forr.udv.
Naturgas
Medisat
Midtjysk
KøleserviceA/S
Markedsel
Energirådgivning
Sygehuse
Kommune
Læger
KOL
Hjertesvigt

33. Questions?
• What is the status of using Telemedicine in
your country?